Early Rehabilitative Exercise Training in the Recovery from Pediatric Burn.

• Autores: Justin P. Hardee, Oscar E. Suman, Craig T. Porter, Labros S. Sidossis, Elisabet Borsheim, David N. Herndon, James A. Carson
• Localización: Medicine & Science in Sports & exercise: Official Journal of the American College of Sports Medicine, ISSN 0195-9131, Vol. 46, Nº. 9, 2014, págs. 1710-1716
• Idioma: inglés
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• Resumen

  • AB Purpose: The purpose of this study was to determine the effects of early outpatient exercise on muscle mass, function, and fractional synthetic rate in severely burned children. Methods: Forty-seven children with >=40% total body surface area burn performed a 12-wk standard of care rehabilitation (SOC, n = 23) or rehabilitative exercise training (RET, n = 24) immediately after hospital discharge. Dual-energy x-ray absorptiometry was used to assess lean body mass (LBM) at discharge, posttreatment, and 12 months post-burn. Muscle function was evaluated with a Biodex Isokinetic Dynamometer, and peak aerobic fitness (V[spacing dot above]O2peak) was measured using a modified Bruce treadmill protocol posttreatment. Stable isotope infusion studies were performed in a subset of patients (SOC, n = 13; RET, n = 11) at discharge and posttreatment to determine mixed-muscle fractional synthetic rate. Results: Relative peak torque (RET, 138 +/- 9 N[middle dot]m[middle dot]kg-1, vs SOC, 106 +/- 9 N[middle dot]m[middle dot]kg-1) and V[spacing dot above]O2peak (RET, 32 +/- 1 mL[middle dot]kg-1[middle dot]min-1, vs SOC, 28 +/- 1 mL[middle dot]kg-1[middle dot]min-1) were greater at posttreatment with RET compared with those with SOC. In addition, RET increased whole-body (9% +/- 2%) and leg (17% +/- 3%) LBM compared with SOC. Furthermore, the percentage change in whole-body (18% +/- 3%) and leg (31% +/- 4%) LBM from discharge to 12 months post-burn was greater with RET compared to SOC. Muscle fractional synthetic rate decreased from discharge to posttreatment in both groups (6.9% +/- 1.1% per day vs 3.4 +/- 0.4% per day); however, no differences were observed between treatment groups at each time point. Conclusions: Early outpatient exercise training implemented at hospital discharge represents an effective intervention to improve muscle mass and function after severe burn injury.